Citation Nr: 18103952
Decision Date: 05/21/18 Archive Date: 05/20/18
DOCKET NO. 14-34 281A
DATE: May 21, 2018
ORDER
Entitlement to an initial rating of 70 percent, but not higher, for the entire period on appeal, for posttraumatic stress disorder (PTSD) is granted.
FINDING OF FACT
For the entire period on appeal, the occupational and social impairment from the Veteran’s PTSD has more nearly approximated deficiencies in most areas.
CONCLUSION OF LAW
The criteria for an initial rating of 70 percent, but not higher, for PTSD have been met for the entire period on appeal. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 4.7, 4.130, Diagnostic Code 9411 (2017).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran had active service in the United States Marine Corps (USMC) from November 1988 to November 1992.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Huntington, West Virginia.
Entitlement to an initial rating of 70 percent for PTSD
The Veteran has asserted that he should have a higher rating for his PTSD as his symptoms are worse than those contemplated by the currently assigned rating.
The Veteran was afforded VA psychiatric examinations in April 2013 and April 2018. There was no evidence or report of any significant change in the breadth or severity of the Veteran’s symptoms across this examination period. The Veteran reported that after service, he became very anxious and nervous. He stated that he would isolate himself from his family by locking himself in the bedroom. It affected his marriage, and he became divorced in 2011. He remarried in January 2018. He described a “fair” relationship with members of his family. He had a low interest in activities, however, he occasionally engaged in golf and fishing. He had the ability to take care of self in his activities of daily living. Following service, the Veteran worked in coal mines from 1993 to 2011. He indicated that he was stressed out, nervous, and overdosed with inpatient treatment and lost his job. He related that he had tried to cope with the stresses of life but he suffered from symptoms of depression, irritability, and anger. He also had problems with low mood and energy, anhedonia, socialization issues, and concentration. He had a history of suicidal ideations. He shared that he disliked crowds and became anxious around people. Thus, he avoided crowds. He described a chronic sleep impairment and service-related nightmares. Additionally, he reported that he had intrusive thoughts and flashbacks. He stated that he became “jumpy” with loud sounds and was hypervigilant. However, he had not experienced any auditory or visual hallucinations. His PTSD symptoms also included disturbances of motivation and mood, mild memory loss, difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances. He was diagnosed with PTSD and unspecified depressive disorder.
A review of mental health treatment records show that the Veteran has received additional treatment at the VA medical center. However, there is no indication from the record that his PTSD symptoms were manifestly different than those reported at his VA examinations.
A review of lay statements, submitted by the Veteran and the Veteran’s family members, indicate that the Veteran turned to drugs and alcohol to help him cope with his mental health issues, to include his anxiety and nervousness. He did not engage in any social activities, and neglected his physical appearance and hygiene. His relationship with his second wife was strained due to mental health and he also did not communicate with his son. The Veteran reported that he missed work because he felt that he had to isolate himself.
The Board finds that the Veteran is entitled to a 70 percent rating throughout the appeal period. In this regard, the Board finds that the Veteran is considered to have occupational and social impairment with deficiencies in most areas. The evidence reflects that the Veteran’s PTSD has been manifested by chronic sleep impairment, anxiety, depression, isolative and avoidant behaviors, hypervigilance, suicidal ideations, loss of interest in activities, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, and intermittent inability to maintain minimal personal hygiene. Therefore, the Board finds that when the Veteran’s disability picture is considered as a whole, it is apparent that the Veteran’s symptoms more closely approximate those contemplated by a 70 percent rating and as such, a higher rating is warranted for PTSD for the entire period on appeal. 38 C.F.R. § 4.130, Diagnostic Code 9411 (2017).
The Board acknowledges that the results of the VA examinations, mental health treatment records, and the symptoms reported by the Veteran and his family members do not indicate that the Veteran has experienced all of the symptoms associated with a 70 percent rating for PTSD. However, the symptoms enumerated under the schedule for rating mental disorders are not intended to constitute an exhaustive list, but rather are intended serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular disability rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Accordingly, the Board finds that there is occupational and social impairment with deficiencies in most areas sufficient to warrant a 70 percent rating even though all the specific symptoms listed for that rating are not manifested.
The Board has considered assigning a higher rating for PTSD. However, there is no indication from the record that the Veteran has had total occupational and social impairment due to his PTSD. In this regard, VA examination reports noted that he demonstrated the ability to perform activities of daily living despite neglect of his personal appearance and hygiene. There is no evidence that he was disoriented or had gross impairment in thought processes or communication. He also exhibited no delusions, hallucinations, or grossly inappropriate behavior. While the Veteran expressed suicidal ideations, he was not in persistent danger of hurting self or others. Although the Veteran was socially isolated to some extent, he was married and maintained a “fair” relationship with members of his family. Moreover, the VA examination reports and VA mental health treatment records did not reflect an assessment of total social and occupational impairment. Therefore, the Board finds that a rating in excess of 70 percent for PTSD is not warranted. 38 C.F.R. §4.130, Diagnostic Code 9411 (2017).
The Board has considered assigning staged ratings. However, at no time during the period in question has the disability warranted a higher schedular rating than that assigned. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).
Kristin Haddock
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD D. Ware, Associate Counsel